Oral Brush Liquid-Based Cytology: A Study of Concordance between a Cytotechnologist and a Cytopathologist

Abstract

Objective: Oral cancer accounts for almost 40% of all cancers in the Indian subcontinent. Techniques like oral scrape cytology are helpful in early diagnosis of premalignant lesion and thus prevention of malignant transformation. The purpose of this study is to evaluate the performance of cytotechnologists in assessing the adequacy and preliminary diagnostic accuracy of oral brush liquid-based cytology. Study Design: 110 oral brush liquid-based cytology smears were prospectively screened by a cytotechnologist for adequacy assessment, and a preliminary diagnosis was recorded. Smears were subsequently studied by the reporting cytopathologist for the final diagnosis. The performance of the cytotechnologist in the assessment of adequacy and the preliminary diagnosis were compared with the final interpretation rendered by the cytopathologist. Results: There was no significant difference in adequacy assessment between both observers, and good concordance was observed in the identification of frankly malignant lesions; however, in premalignant cases, complete agreement in all the cases was not observed. Maximum numbers of discrepant cases were seen in high-grade squamous intraepithelial lesions, 4/17 were downgraded to low-grade squamous intraepithelial lesions and 2/17 to negative for intraepithelial lesion or malignancy, respectively. Conclusion: Trained cytotechnologists are capable of assessing the adequacy and identifying the malignancy in oral brush liquid-based cytology smears, and hence there is potential for them to perform initial screening of such cases.

Cytology-based Cancer Surgery of the Head and Neck (CyCaS-HN): a prospective, randomized, controlled clinical trial

“…Therefore, we recommend the strategy of cytology-based head and neck cancer surgery when a trained cytopathologist is available and is introduced to this therapeutic concept. As Pandey et al [ 28 ] found a high level of concordance without any significant difference when evaluating the performance of cytotechnologists and cytopathologists in assessing the adequacy and preliminary diagnostic accuracy of oral brush liquid-based cytology, it represents an alternative to involve experiences cytotechnologists in the evaluation of oral LBC specimens when a trained cytopathologist is not available. Even an automated analysis of LBC samples of the head and neck region using artificial intelligence has been investigated with promising preliminary results giving reasons for further studies [ 29 ].…”

Absence of Synergistic Effect of Toluidine Blue and Cytomorphometry in Discriminating Dysplasia in Oral Exfoliative Cytology

“…The researcher performed a computerized analysis of cytology to remove the subjective bias and improve the inter-observer agreement. [7,20,21] The histomorphometric analysis of exfoliative cells from normal mucosa and oral premalignant lesions in these studies was found to be effective in differentiating between dysplastic and non-dysplastic cells, thereby helping in the diagnosis of the dysplastic lesion. These reported a decrease in CA and CD; an increase in NA, and ND, and an increase NACA, and NDCD ratio in dysplastic cells as compared to normal cells.…”